Doctor Name: | KIMBERLY GOULD |
NPI Number: | 1457763146 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2013044075 |
Business Practice Address: | 4801 Weldon Spring Pkwy Weldon Spring, MO - 633049101 |
Business Phone Number: | 6364772180 |
Business Fax Number: | 6364772185 |
Mailing Address: | 5000 Cedar Plaza Pkwy, Suite 350 SAINT LOUIS |
State: | MO |
Postal Code: | 631283854 |
Phone Number: | 3148434333 |
Fax Number: | 3148420772 |
NPI Enumeration Date: | 05/29/2014 |
NPI Last Update Date: | 05/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 2013044075 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |